The authors describe an intervention for work refusals in a 49-year-old man with mild mental retardation, more commonly referred to as mild intellectual disability, and other comorbid Axis I diagnoses. Following a behavioral functional assessment, Intervention A, contingent reinforcement of work attendance with cigarettes and edibles was implemented to increase work attendance. A modified reversal to baseline (Intervention B) retained the contingent reinforcement with edibles but not cigarettes. Following Intervention B, a third intervention (Intervention C) reintroduced contingent reinforcement of work attendance with cigarettes and edibles in addition to a response cost procedure. Contingent reinforcement using the most preferred reinforcer was found to be an effective intervention in increasing work attendance; however, this intervention combined with response cost was found to be superior. Overall, a 45.4% decrease in work refusals was seen from baseline following implementation of contingent reinforcement using cigarettes and edibles (Intervention A), whereas a 65.1% decrease was seen between baseline and contingent reinforcement using cigarettes and edibles combined with response cost (Intervention C). Such decrease in work refusals was maintained during follow-up. Factors responsible for intervention success and implications for clinicians are discussed.
Applegate, H., Matson, J.L., & Cherry, K.E. ( 1999). An evaluation of functional variables affecting severe problem behaviors in adults with mental retardation by using the Questions About Behavioral Function scale (QABF). Research in Developmental Disabilities, 20, 229-237.
2.
Athens, E.S., Vollmer, T.R., Sloman, K.N., & St. Peter Pipkin, C. (2008). An analysis of vocal stereotypy and therapist fading. Journal of Applied Behavior Analysis, 41, 291-297.
3.
Carr, J.E., Severtson, J.M., & Lepper, T.L. ( 2009). Noncontingent reinforcement is an empirically supported treatment for problem behaviors exhibited by individuals with developmental disabilities. Research in Developmental Disabilities, 30, 44-57.
4.
Cataldo, M.F., Ward, E.M., Russo, D.C., Riordan, M., & Bennett, D. ( 1986). Compliance and correlated problem behavior in children: Effects of contingent and noncontingent reinforcement. Analysis and Intervention in Developmental Disabilities, 6, 265-282.
5.
DeLeon, I.G., Fisher, W.W., Rodriguez-Catter, V., Maglieri, K., Herman, K., & Marhefka, J.-M. (2001). Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments. Journal of Applied Behavior Analysis, 34, 463-473.
6.
DeLeon, I.G., Iwata, B.A., Goh, H.-L., & Worsdell, A.S. (1997). Emergence of reinforcer preference as a function of schedule requirements and stimulus similarity . Journal of Applied Behavior Analysis, 30, 439-449.
7.
Didden, R. ( 2007). Functional analysis methodology in developmental disabilities . In P. Sturmey (Ed.), Functional analysis in clinical treatment (pp. 65-86). London , UK: Elsevier.
8.
Doleys, D.M., Wells, K.C., Hobbs, S.A., Roberts, M.W., & Cartelli, L.M. (1976). The effects of social punishment on noncompliance: A comparison with timeout and positive practice . Journal of Applied Behavior Analysis, 9, 471-482.
9.
Emerson, E., Kiernan, C., Alborz, A., Reeves, D., Mason, H., Swarbrick, R., . . . Hatton, C. ( 2001). The prevalence of challenging behaviors: A total population study. Research in Developmental Disabilities, 22, 77-93.
10.
Epstein, L.H., & Masek, B.J. ( 1978). Behavioral control of medicine compliance. Journal of Applied Behavior Analysis, 11, 1-9.
11.
Farmer, C.A., & Aman, M.G. ( 2009). Development of the Children’s Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP). Research in Developmental Disabilities, 30, 1155-1167.
12.
Farrar-Schneider, D. ( 1994). Aggression and noncompliance: Behavior modification . In J. L. Matson (Ed.), Autism in children and adults: Etiology, assessment, and intervention (pp. 181-191). Pacific Grove, CA: Brooks/Cole Publishing.
13.
Fisher, W., Piazza, C.C., Bowman, L.G., Hagopian, L.P., Owens, J.C., & Slevin, I. ( 1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491-498.
14.
Goetz, E.M., Holmberg, M.C., & LeBlanc, J.M. ( 1975). Differential reinforcement of other behavior and noncontingent reinforcement as control procedures during the modification of a preschooler’s noncompliance. Journal of Applied Behavior Analysis, 8, 77-82.
15.
Gottschalk, J.M., Libby, M.E., & Graff, R.B. ( 2000). The effects of establishing operations on preference assessment outcomes. Journal of Applied Behavior Analysis , 33, 85-88.
16.
Graff, R.B., Gibson, L., & Galiatsatos, G.T. (2006). The impact of high- and low-preference stimuli on vocational and academic performances of youths with severe disabilities. Journal of Applied Behavior Analysis , 39, 131-135.
Handen, B.L., Parrish, J.M., McClung, T.J., Kerwin, M.E., & Evans, L.D. ( 1992). Using guided compliance versus time out to promote child compliance: A preliminary comparative analysis in an analogue context . Research in Developmental Disabilities, 13, 157-170.
19.
Holden, B., & Gitlesen, J.P. (2006). A total population study of challenging behaviour in the county of Hedmark, Norway: Prevalence and risk markers. Research in Developmental Disabilities, 27, 456-465.
20.
Little, L.M., & Kelley, M.L. ( 1989). The efficacy of response cost procedures for reducing children’s noncompliance to parental instructions. Behavior Therapy, 20, 525-534.
21.
Lowe, K., Allen, D., Jones, E., Brophy, S., Moore, K., & James, W. ( 2007). Challenging behaviours: Prevalence and topographies . Journal of Intellectual & Developmental Disability , 51, 625-636.
22.
Matson, J.L., Bamburg, J.W., Cherry, K.E., & Paclawskyj, T.R. (1999). A validity study on the Questions About Behavioral Function (QABF) Scale: Predicting treatment success for self-injury, aggression, and stereotypies. Research in Developmental Disabilities, 20, 163-175.
23.
Matson, J.L., & Boisjoli, J.A. (2009). The token economy for children with intellectual disability and/ or autism: A review. Research in Developmental Disabilities, 30, 240-248.
24.
Matson, J.L., & Dempsey, T. ( 2009). The nature and treatment of compulsions, obsessions, and rituals in people with developmental disabilities. Research in Developmental Disabilities, 30, 603-611.
Matson, J.L., & Neal, D. ( 2009). Psychotropic medication use for challenging behaviors in persons with intellectual disabilities: An overview. Research in Developmental Disabilities, 30, 572-586.
27.
Myrbakk, E., & von Tetzchner, S. (2008). The prevalence of behavior problems among people with intellectual disability living in community settings . Journal of Mental Health Research in Intellectual Disabilities , 1, 205-222.
28.
Nicholson, J., Konstantinidi, E., & Furniss, F. ( 2006). On some psychometric properties of the Questions About Behavioral Function (QABF) Scale. Research in Developmental Disabilities, 27, 337-352.
29.
Paclawskyj, T.R., Matson, J.L., Rush, K.S., Smalls, Y., & Vollmer, T.R. ( 2000). Questions About Behavioral Function (QABF): A behavioral checklist for functional assessment of aberrant behavior. Research in Developmental Disabilities, 21, 223-229.
30.
Paclawskyj, T.R., Matson, J.L., Rush, K.S., Smalls, Y., & Vollmer, T.R. ( 2001). Assessment of the convergent validity of the Questions About Behavioral Function Scale with analogue functional analysis and the Motivation Assessment Scale. Journal of Intellectual Disability Research, 45, 484-494.
31.
Parrish, J.M., Cataldo, M.F., Kolko, D.J., Neef, N.A., & Egel, A.L. ( 1986). Experimental analysis of response covariations among compliant and inappropriate behaviors. Journal of Applied Behavioral Analysis, 19, 241-254.
32.
Petscher, E.S., Rey, C., & Bailey, J.S. ( 2009). A review of empirical support for differential reinforcement of alternative behavior. Research in Developmental Disabilities , 30, 409-425.
33.
Piazza, C.C., Fisher, W.W., Hagopian, L.P., Bowman, L.G., & Toole, L. ( 1996). Using a choice assessment to predict reinforcer effectiveness . Journal of Applied Behavioral Analysis, 29, 1-9.
34.
Reed, G.K., Ringdahl, J.E., Wacker, D.P., Barretto, A., & Andelman, A.S. (2005). The effects of fixed-time and contingent schedules of negative reinforcement on compliance and aberrant behavior. Research in Developmental Disabilities, 26, 281-295.
35.
Ringdahl, J.E., Kopelman, T., & Falcomata, T.S. (2009). Applied behavior analysis and its application to autism and autism related disorders. In J. L. Matson (Ed.), Applied behavior analysis for children with autism spectrum disorders (pp. 15-32). New York, NY: Springer.
36.
Russo, D.C., Cataldo, M.F., & Cushing, P.J. ( 1981). Compliance training and behavioral covariation in the treatment of multiple behavior problems. Journal of Applied Behavioral Analysis, 14, 209-222.
37.
Singh, A.N., Matson, J.L., Mouttapa, M., Pella, R.D., Hill, B.D., & Thorson, R. ( 2009). A critical item analysis of the QABF: Development of a short form assessment instrument. Research in Developmental Disabilities, 30, 782-792.
38.
Slifer, K.J., Avis, K.T., & Frutchey, R.A. (2008). Behavioral intervention to increase compliance with electroencephalographic procedures in children with developmental disabilities. Epilepsy & Behavior, 13, 189-195.
39.
Snyder, R., Turgay, A., Aman, M., Binder, C., Fisman, S., & Carroll, A. ( 2002). Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQs. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 1026-1036.
40.
Strachan, R., Shaw, R., Burrow, C., Horsler, K., Allen, D., & Oliver, C. ( 2009). Experimental functional analysis of aggression in children with Angelman syndrome. Research in Developmental Disabilities , 30, 1095-1106.
41.
Walker, G.R. ( 1993). Noncompliant behavior of people with mental retardation . Research in Developmental Disabilities, 14, 87-105.
42.
Wechsler, D. ( 1981). Wechsler Adult Intelligence Scale-Revised. New York, NY: The Psychological Corporation .
43.
Wechsler, D. ( 1997). Wechsler Adult Intelligence Scale-Third Edition. San Antonio, TX: The Psychological Corporation.
44.
Young, A.T., & Hawkins, J. ( 2002). Psychotropic medication prescriptions: An analysis of the reasons people with mental retardation are prescribed psychotropic medication . Journal of Developmental and Physical Disabilities , 14, 129-142.
